Healthcare Provider Details

I. General information

NPI: 1356433981
Provider Name (Legal Business Name): MICHAEL BRENDAN DUNN PHARM.D., BCPS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 09/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VA SAN DIEGO HEALTHCARE SYSTEM PHARMACY # 119 3350 LA JOLLA VILLAGE DRIVE
SAN DIEGO CA
92161-0001
US

IV. Provider business mailing address

8823 SPECTRUM CENTER BLVD APT #2312
SAN DIEGO CA
92123-1456
US

V. Phone/Fax

Practice location:
  • Phone: 858-552-8585
  • Fax: 858-552-7582
Mailing address:
  • Phone: 858-395-6042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number58480
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: